Endoscopic Submucosal Dissection for Gastrointestinal Mesenchymal Tumors Adjacent to the Esophagogastric Junction: We Need to Do More

Abstract Objective: Extensive surgery is the mainstay of therapy for patients with gastrointestinal mesenchymal tumors (GIMTs) adjacent to the esophagogastric junction (EGJ). However, this modality is invasive and may interfere with anatomic consistency of the digestive tract. Therefore, we evaluated the feasibility, safety, and efficacy of endoscopic submucosal dissection (ESD) for GIMTs close to the EGJ and factors related to incomplete resection. Patients and Methods: For 39 GIMTs adjacent to the EGJ in 39 consecutive patients, the baseline information, complications, and therapeutic outcomes were recorded. Subsequently, risk factors, focusing on age, sex, tumor size, extent, shape, perforation presence/absence, and histopathology, were analyzed. Results: Complete removal of junctional GIMTs was achieved in 32 cases, giving an overall complete resection rate of 82%. The mean tumor size was 16.1±12.7 (median, 12; range, 4–50) mm. There were no major intra- and postoperative complications, but two small ...